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Share & Learn

Planning a Project - Tools

Driver Diagrams

22 February 2023

Outcomes

• How to develop a project aim
• What a Driver Diagram is
• When to use a Driver Diagram
• How to build a Driver Diagram
• Understand primary drivers, secondary drivers and change ideas
• Benefits of using a Driver Diagram
• Where to find resources

Project Aims

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• All improvement projects need a clearly defined aim.
• The aim should be a description of the desired outcome and should answer the question, ‘What are we trying to accomplish?’

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Aim should be clearly defined and measurable

Think SMART:

Example:

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Aim: To ensure that all patients who are eligible for study X are offered the opportunity to participate in the study

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Aim: To ensure that 80% of patients presenting to the Emergency Department and who are eligible for study X are offered the opportunity to participate within the next 4 months

What is a Driver Diagram?

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• A driver diagram is an immensely powerful tool that helps you to break down an improvement goal/aim into a logical set of underpinning goals and projects.
• Demonstrates the links between causes (changes) and effect (outcome).
• It summarises the required change and ideas which may result in an improvement
• A way of clearly communicating to a range of stakeholders

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When to use a Driver Diagram?

• During the initial planning stages of your improvement work / project
• Addressing complex change
• To show your theories of cause and effect in your system
• Good to revisit and update whenever you are reviewing your data or generating ideas

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4 Key elements

The ultimate aim of a driver diagram is to define the range of projects (ie actual change initiatives) that you need to undertake in order to reach your aim.

Aim: What do we want to achieve.

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Is is specific, realistic, measurable and timely (by how much, by when)

The driver diagram starts with a clearly defined and measurable aim. This is the focal point for your change efforts.

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As we move right we start to identify the goals (drivers) needed in order to achieve the aim.

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Primary Drivers - key factors that drive the outcome/aim

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Secondary Drivers - activities which influence the primary drivers, usually more specific.

This helps to then identify interventions that will drive improvement.

Change Idea

Change Idea

Change Idea

Change Idea

Change Idea

Change Idea

Change Idea

Change Idea

Aim: An improved system

Change Ideas

• Specific ideas for you or your team to test to help move towards the aim.
• All change ideas should have an effect on at least one Secondary Driver. By association, all change ideas are expected to help achieve the aim
• Prioritise change ideas according to which is likely to have the highest and/or quickest impact
• Test your change ideas using PDSA cycles

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Driver diagram example

Example - Primary drivers

To ensure that 80% of patients presenting to the Emergency Department and who are eligible for study X are offered the opportunity to participate within the next 4 months

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ED staff competency

Example - Secondary drivers

To ensure that 80% of patients presenting to the Emergency Department and who are eligible for study X are offered the opportunity to participate within the next 4 months

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Education

Communication

Appropriate training

Staff levels

Time pressures

ED staff competency

Example - Change ideas

Structured teaching sessions

Change Idea

GCP, consent training, study specific training

Email correspondence, face to face opportunities

To ensure that 80% of patients presenting to the Emergency Department and who are eligible for study X are offered the opportunity to participate within the next 4 months

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Education

Communication

Appropriate training

Staff levels

Time pressures

ED staff competency

Benefits of using driver diagrams

• Helps communicate the overall aim, drivers and interventions
• Helps explore the factors that need to be addressed in order to achieve a specific goal
• The production of the diagram supports team working and commitment to agreed goals and priorities
• Highlights how factors are connected
• Allows generation of ideas that impact on the overall outcome
• Provides the basis for identifying measures for the project

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Top tips

• Include all relevant stakeholders
• Ensure you have a clear aim statement
• Regular review of your driver diagrams
• Be flexible when creating
• Don’t jump straight to change ideas, make sure you establish drivers first

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Summary

Driver diagrams are a visual tool, prepared at the start of a project, which assist teams in doing improvement projects.

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• Used by teams to generate change ideas that will help achieve their overall aim.
• Act as a tool for developing measures and understanding where each is relevant.
• Communicates to others the design of the project.
• Helps staff to understand how their work contributes to overall aim.

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Resources

• Driver Diagrams Guidance (NHS England)
• Driver Diagrams - further reading (QI ELFT)
• Driver Diagram example
• Driver Diagram tool (Excel)
• Driver Diagram tool (online)
• CI Tools & Resources